Antibiotic May Protect Thousands from Deadly TB

Tuberculosis is often a death sentence for Vietnamese people diagnosed with a nasty drug-resistant form of the lung disease.

But researchers at the Woolcock Institute of Medical Research in Sydney are working to change that with the help of an antibiotic they hope could protect thousands of relatives from catching the deadly disease from their sick loved ones.

If successful, the five-year project will grab the attention of policy makers worldwide and change the face of TB treatment in both developed and developing nations.

Tuberculosis, a bacterial lung infection, is a major problem in Vietnam where 190,000 people live with the disease. TB killed 19,000 residents in 2013, many of whom had been diagnosed with a hard-to-treat multi-drug resistant type that can be fatal.

"The drugs to treat it are expensive, toxic, slow working and frankly not very effective, so the prognosis for these patients is often not good," says respiratory physician Dr Greg Fox, a chief investigator on the study, supported by a $3.2 million NHMRC grant. "We're hoping to change all that."

The research team is looking to halt the spread of the contagious disease with an antibiotic called levofloxacin that will be given to relatives of TB patients.

As Dr Fox explains, family members are at high risk of becoming infected with the bacteria, a state called 'latent TB infection' that can later progress to active TB. 

Antibiotics are known to help prevent TB in relatives with standard drug-susceptible disease but the effectiveness of preventive therapy for family of patients with the more deadly multi-drug resistant form is yet to be tested.

Researchers based at Woolcock's Vietnam office will put it to the test with a randomised controlled trial of 3000 relatives to be recruited over three years from 10 provinces across the country. 

These patients will take either the antibiotic or a placebo pill daily for six months, with follow-ups for two more years to see who develops TB.

 If results show levofloxacin therapy prevents drug-resistant TB then it will have major implications for control of the disease, Dr Fox says.

"This would be a transformative advance in knowledge about this type of tuberculosis, and something that would be of considerable interest to clinicians and health authorities the world over," he says.

"But most importantly, such a discovery has the potential to protect tens of thousands of people from the suffering and death too often associated with this disease."

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February 2015